Measurement

This section includes measurement and evaluation resources. Access to standardized developmental screening is an important measure of the quality of pediatric primary care. For that reason, the CHIPRA Core Set of Children’s Health Care Quality Measures includes an indicator of access to developmental screening (DEV-CH) for children enrolled in Medicaid and CHIP. This measure, developed at Oregon Health and Science University, is used to monitor the receipt of developmental screening during each of the first three years of a child’s life. Twenty-seven states voluntarily reported the measure to the Centers for Medicare & Medicaid Services (CMS) in 2017. See the map below for more information. With more than 25 states reporting the measure in FFYs 2016 and 2017, state data is available from CMS. Scroll down to the zip file Performance on the Child Core Set Measures, FFY 2016 and FFY 2017.

The National Survey of Children’s Health includes an indicator of access to developmental screening for children aged 10 months to 5 years, based on parental reports. HRSA’s Title V Maternal and Child Health Block Grant program includes a national performance measure (NPM 6) that monitors developmental screening using this indicator. Forty-two state Title V programs have prioritized this performance measure.

States agencies may use the above or other measures internally to monitor access to developmental screening. Measures may be used in Medicaid performance improvement projects or other quality monitoring efforts. See the Medicaid Incentives and Improvement Projects map below to learn more.

Because these measures rely on different data sources (e.g., Medicaid claims, medical chart reviews, parent telephone surveys) and specifications, developmental screening measurement is not aligned across systems or programs.

State Reporting of CHIPRA Developmental Screening Core Measure

CHIPRA Core Measure

Legend:

Currently report the measure (27)

Previously reported the measure (2)

Do not report the measure (24)

Sources: 2011, 2012, 2013, 2014, 2015 Annual Reports on the Quality of Care for Children in Medicaid and CHIP; 2016, 2017, 2018 Annual Reporting on the Quality of Care for Children in Medicaid and CHIP Chart Packs

Policy Trends

There was a 13-fold increase in the number of states reporting the CHIPRA core measure for developmental screening between 2010 to 2017 (from 2 to 27 states).

The number of states reporting the measure increased most between 2012 (12) to 2013 (20).

As of 2017 (the most current data, released in 2018), 29 states have historically reported the measure while 22 states have never reported the measure.

One state (Arizona) reported the measure for the first known time in 2017.

State Medicaid Incentives or Improvement Projects for Developmental Screening

Incentives & IPs

Legend:

Incentive (5)

Improvement Project (3)

Both (1)

Policy Trends

9 states have a Medicaid performance improvement project and/or incentive for developmental screening.

3 states (Connecticut, Massachusetts, Oregon) have or are in the process of implementing an incentive metric for developmental screening as part of broad Medicaid payment or delivery reform, such as a State Innovation Model grant-funded initiative.

This information is based on 2016 NASHP research funded by the Health Resources and Services Administration. Please email nmention@nashp.org with any updates.